Category: Flu Virus

The Centers for Disease Control and Prevention are urging Americans to take holiday health precautions as respiratory viruses continue spreading nationwide. (Photo: CBS Austin)

AUSTIN, Texas

The Centers for Disease Control and Prevention are urging Americans to take holiday health precautions as respiratory viruses continue spreading nationwide.

Influenza, COVID-19, and RSV are all circulating right now. According to data from the Texas Department of State Health Services, flu activity is considered high and continuing to climb.

"We've noticed definitely a big uptick in flu, a small rise in COVID and still having lingering effects of RSV," said Dr. Vard Curtis, emergency department medical director at St. David's South Austin Medical Center. His ER is seeing typical seasonal increases in respiratory viruses.

"There's a lot of overlap between flu and COVID so the testing is what we rely on. They both cause high fevers, really bad body aches, often cough, sometimes shortness of breath, runny nose, no energy," said Curtis.

The same guidance issued during the pandemic applies now:

"Flu to you and me can be a couple of days of feeling lousy, but flu to an elderly person or someone with a kidney transplant or cancer diagnosis... it can be fatal," said Curtis.

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Statewide, positive flu tests in hospitals are up 5.5 percent from the previous week, according to Texas DSHS. The latest data shows that 15 percent of flu tests in Texas are positive. In Austin, about 10 percent of flu and COVID tests are positive, according to Austin Public Health.

"Know there are a lot of people who are out there doing home testing, so that COVID number may not represent the total number of cases that are out there in the community," said Desmar Walkes, Austin-Travis County Health Authority.

Austin Public Health is urging people to think twice before gathering with others when feeling under the weather.

"We're going to be hugging and sharing meals and laughing and enjoying this holiday season, and its best to do that if you're not sick, so you're not spreading it to loved ones-- especially those that can't fight off infection as well," said Walkes.

According to the CDC, this year's influenza and COVID-19 vaccines are proving to be a pretty good match for the strains of the virus going around. Influenza typically peaks between December and February but flu season lasts until May.

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Influenza, COVID-19 cases on the rise in Central Texas - KEYE TV CBS Austin

Author affiliations: School of Public Health, The University of Hong Kong, Hong Kong, China (P. Daulagala, S.M.S. Cheng, A. Chin, L.H.L. Luk, K. Leung, J.T. Wu, L.L.M. Poon, M. Peiris, H.L. Yen); The University of Hong KongShenzhen Hospital, Shenzhen, China (K. Leung); Centre for Immunology and Infection, Hong Kong Science Park, Hong Kong (L.L.M. Poon, M. Peiris)

The A/goose/Guangdong/1/1996-like (GsGD-like) highly pathogenic avian influenza A(H5N1) viruses were first identified in 1996 and have continuously evolved into antigenically distinct hemagglutinin (HA) clades that have substantially affected animal and human health. Before 2005, the GsGd-like virus mainly circulated in Asia among domestic poultry. Spillover infections from domestic poultry to wild migratory birds have enabled intercontinental spread to Europe, the Middle East, Africa, and North America, as previously observed in 2005 (clade 2.2 virus) and in 20142015 (clade 2.3.4.4c virus) (1). Since 2016, the clade 2.3.4.4b viruses have undergone a 3rd wave of intercontinental spread and have become enzootic among wild birds as of 2021 (2,3). Currently, the GsGD-like H5N1 viruses have been reported in all continents except Oceania and Antarctica. Expanded genetic diversity and geographic distribution has led to spillover events into numerous mammal species and sporadic human infections (4).

Highly pathogenic avian influenza A(H5N1) virus has not yet achieved efficient transmissibility in humans, but the current epidemiology of H5N1 2.3.4.4b lineage raises concerns of possible pandemic potential. Population immunity to an emerging influenza virus is one of the key parameters considered in assessing its pandemic risk according to the Centers for Disease Control and Prevention influenza risk assessment tool (https://www.cdc.gov/flu/pandemic-resources/national-strategy/risk-assessment.htm) and the World Health Organization tool for influenza pandemic risk assessment (https://www.who.int/teams/global-influenza-programme/avian-influenza/tool-for-influenza-pandemic-risk-assessment-(tipra)). Neutralizing antibodies targeting the HA receptor-binding domain and antibodies that inhibit neuraminidase (NA) activity have been shown to correlate with protection against influenza infection (5,6). We evaluated whether healthy adults possess cross-reactive hemagglutination inhibition (HAI) and neuraminidase inhibition (NAI) antibodies to H5N1 virus through previous exposure to seasonal influenza infections.

We collected serum samples from 63 healthy blood donors 1873 years of age in 2020 in Hong Kong (HKU/HA HKW IRB #UW-132) to determine cross-reactive HAI antibodies and NAI antibodies to a clade 2.3.4.4b H5N1 virus (A/black-faced spoonbill/Hong Kong/AFCD-HKU-22-21429-01012/2022; Spoonbill/HK/22), which showed high homology to the HA and NA proteins of clade 2.3.4.4b candidate vaccine viruses A/chicken/Ghana/AVL-76321VIR7050-39/2021 (98.8% [HA] and 97.3% [NA]) and A/American wigeon/South Carolina/AH0195145/2021 (98.6% [HA] and 97.2% [NA]) (7). For comparison, we also determined the HAI and NAI antibody responses to the 2009 pandemic influenza A(H1N1)pdm09 (pH1N1) virus (A/California/04/2009; California/09) using an HAI assay and enzyme-linked lectin assay (detection limit at 1:10) (8,9).

Figure

Figure. Age-stratified HAI and NAI antibody responses to influenza A(H1N1)pdm09 (California/09) and A(H5N1) (Spoonbill/HK/22) viruses in serum samples collected from healthy adults in 2020 and 2009, Hong Kong, China. A, B)...

Among healthy adults, 56/63 (88.8%) possessed HAI antibodies to pH1N1 virus with a geometric mean titer (GMT) of 21.84; none showed detectable HAI antibodies to H5N1 virus (Figure, panel A). NAI antibodies against pH1N1 were detected in 57/63 (90.5%) healthy participants (GMT 41.80), and 61/63 (96.8%) also possessed cross-reactive NAI antibodies to H5N1 (GMT 41.34) (Figure, panel B). The NAI titers against pH1N1 and H5N1 were highly correlated (Spearman =0.8349; p<0.001) (Appendix Figure 1). Furthermore, 57 (90.5%) persons had NAI antibodies to both viruses at titers >1:10, and 32 (50.8%) persons had NAI antibodies to both viruses at titers >1:40. To evaluate whether the cross-reactivity extends to N1 proteins of other avian influenza viruses, we randomly selected 32 serum samples to determine NAI titers against an avian influenza A(H6N1) virus isolated from wild bird surveillance (A/environment/Hong Kong/HKU_MPT_2006/2015; Env/HK/15). DNA barcoding suggested that the specimen originated from Platalea minor (black-face spoonbill). Similarly, 93.75% (30/32) persons possessed cross-reactive NAI titers against H6N1 virus (GMT 26.50), and 40.6% (13/32) possessed NAI titers >1:40 (Appendix Figure 1). However, cross-reactivity did not extend to N4 protein of an avian influenza A(H6N4) virus isolated from wild bird surveillance (A/environment/Hong Kong/HKU_MPT_2022; Env/HK/22) originated from Anas acuta (northern pintail) (Appendix Figure 1). Overall, we observed high correlations between NAI titers against pH1N1 and H6N1 viruses (Spearman =0.875; p<0.001) and between H5N1 and H6N1 viruses (Spearman =0.874; p<0.001).

We examined NAI titers to the homologous virus and cross-reaction to H5N1 virus in archival ferret antiserum against seasonal A(H1N1) viruses and pH1N1 (Table 1). Ferret antiserum against H1N1 viruses circulating during 19772007 showed no cross-reactive NAI response to H5N1 but had NAI titers at 1:3201:1280 against the homologous viruses. Ferret antiserum against pH1N1 virus showed a homologous NAI titer of 1:2,560 and cross-reactive NAI titers to H5N1 at 1:320 to 1:640.

To further confirm whether exposure to pH1N1 virus contributed to the cross-reactive NAI antibodies, we used serum samples of 50 healthy blood donors (1755 years of age) collected in July 2009, before pH1N1 had become widespread in Hong Kong (11). HAI antibodies to pH1N1 were detected in 22% (11/50) of the samples; GMT was low, at 7.07 (Figure, panel C). We detected NAI antibodies to pH1N1 in 40% (20/50) of healthy blood donors; GMT was low, at 8.24. NAI antibodies to H5N1 were detected in 40% (22/50) of donors; GMT was 8.35 (Figure, panel D). Most participants (16/20) with detectable NAI antibodies to pH1N1 also had NAI antibodies to H5N1. Overall, the cross-reactive NAI titers detected in 2009 (Figure, panel D) were lower than the those detected in 2020 (Figure, panel B). This result suggests that previous exposure to pH1N1 virus is the potential source of cross-reactive NAI antibodies to H5N1 virus. The NA protein of Spoonbill/HK/22 differed from the pH1N1 (California/09) NA by 53 aa and from the seasonal H1N1 NA proteins by 6876 aa; most changes occurred in the NA head domain (Table 2; Appendix Figure 2).

We detected high titers of cross-reactive NAI antibodies to clade 2.3.4.4b H5N1 virus, Spoonbill/HK/22, in samples collected from healthy adults 1873 years of age in 2020. The N1 antibody cross-reactivity also extended to an H6N1 avian influenza virus isolated from wild bird samples in Hong Kong. Our results confirm and extend the findings from a recent study reporting cross-reactive NAI antibody responses to clade 2.3.4.4b H5N1 virus in healthy blood donors (12). The use of monospecific archival ferret antiserum against seasonal H1N1 and pH1N1 influenza showed that cross-reactive NAI response to H5N1 were elicited by pH1N1 but not by seasonal H1N1 viruses circulating during 19772007. The pH1N1 virus derived its NA protein from the avian-origin Eurasian-avian swine viruses (13) and appeared antigenically more closely related to the N1 of H5N1 and H6N1 avian influenza viruses but not to a N4 of H6N4 avian influenza virus. The use of serum samples collected from healthy blood donors in 2009 further confirmed that exposure to pH1N1 might have contributed to the cross-reactive NAI antibodies against H5N1.

HAI titer of >1:40 has long been established to correspond with a 50% reduction in influenza infection risk, which might be used to model the effects of cross-reactive HAI antibody titers on reducing the basic reproduction number (R0) of novel zoonotic viruses with pandemic potential (14). NAI antibodies have also been shown to protect against infection, reduce symptoms, and shorten the duration of viral shedding (5,6); however, the NAI antibody threshold that corresponds with protection has not been clearly defined.

In summary, we detected high titers of cross-reactive NAI antibodies against influenza A(H5N1) clade 2.3.4.4b virus in serum samples collected from healthy adults in 2020 but not detected in serum samples collected in 2009. Further studies are needed to confirm whether cross-reactive NAI antibodies confer protection against H5N1 infection or modulate disease severity, but our results suggest that the antibodies against H5N1 and H6N1 viruses might derive from exposure to the conserved epitopes shared between the avian-origin pH1N1 virus and avian N1 proteins.

Dr. Daulagala is a researcher at the School of Public Health, University of Hong Kong. Her primary research interest is understanding the role of neuraminidase antibodies in influenza infections.

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We thank Christopher J. Brackman and the Agriculture Fisheries and Conservation Department, Government of the Hong Kong Special Administrative Region, China, for sharing the A(H5N1) virus.

This study was supported by RGC Theme-based Research Schemes (T11-712/19-N) of the Research Grant Council and Health@InnoHK (Centre for Immunology and Infection) administered by Innovation and Technology Commission, Hong Kong, China.

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

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Avian Influenza A(H5N1) Neuraminidase Inhibition Antibodies in Healthy Adults after Exposure to Influenza A(H1N1 ... - CDC

Over the last three years, a highly contagious, often deadly form of bird flu has taken a staggering toll on animals around the globe.

The virus, known as H5N1, has infected birds in more than 80 countries. It has infiltrated big commercial poultry farms and tiny backyard henhouses, affecting 72 million farmed birds in the United States alone, according to the Department of Agriculture. It has struck a wide range of wild bird species, killing gulls and terns by the thousand. And it has turned up repeatedly in mammals, including foxes, skunks, bears, cats, sea lions and dolphins. (It has also caused a small number of deaths in people, primarily in those who had close contact with birds. The risk to the general public remains low, experts say.)

The virus is not done yet. It is surging again in Europe and North America and causing mass animal mortality events in South America. It also appears to be spreading in the Antarctic region for the first time.

It continues to be unprecedented, said Thomas Peacock, a virologist at the Pirbright Institute in England. By several measures, were at the worst its ever been, particularly in terms of geographical spread, how widespread it is in birds and how many mammals are getting infected.

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Bird Flu Is Still Causing Havoc. Here's the Latest. - The New York Times

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Existing flu vaccines provide only limited, seasonal protection because they target highly changeable proteins on the virus. Scripps Research scientists have now designed a vaccine that should work broadly against influenza A strainsone of the two types of flu virus that normally circulate in humans.

The new vaccine design, described in a paper inACS Nanoon November 21, uses a relatively unchanging influenza A protein fragment, M2e, and presents it on self-assembling nanoparticles to better engage the immune system. The vaccines strong results in initial animal tests point to the possibility of a universal flu vaccine that provides long-term protection against serious illness from both ordinary and novel flu strains.

This experimental vaccine has the potential to protect against diverse seasonal influenza A strains as well as future emergent strains that could cause pandemics, says study senior authorJiang Zhu, PhD, an associate professor in the Department of Integrative Structural and Computational Biology at Scripps Research.

The co-first authors of the study were postdoctoral research associate Keegan Braz Gomes, PhD, and staff scientist Yi-Nan Zhang, PhD, both of the Zhu Lab.

M2e is the small, external portion of M2, a protein embedded in the outer envelope of flu viruses. Because M2 has a critical role in the flu virus life cycle, it and M2e are largely the same from one flu A strain to the next. The fact that it is so well conserved across strains suggests that M2e could be a good target for a broadly effective flu vaccine.

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Like other vaccines developed by the Zhu Lab in recent yearsincluding HIV, SARS-CoV-2, and Hepatitis C virus vaccinesthe new vaccine presents viral proteins to the immune system not as individual loose protein copies but, rather, mounted on large nanoparticles. This nanoparticle-based design looks to the immune system more like a real virus, which leads to greater immune stimulation. The nanoparticles are self-assembling, highly stable, and easy to manufacture using biotech methods; each is studded with dozens of copies of the targeted viral protein.

In the new study, the researchers began with a nanoparticle-based design that used a version of M2e from a human-infecting influenza A strain, H1N1. This protected ten out of ten mice from sequential, high-dose exposures to live H1N1 virus and a very different influenza A strain called H3N2. In contrast, unvaccinated mice rapidly succumbed to viral exposure, as did most of the mice vaccinated with a non-nanoparticle version of M2e.

The team obtained similarly promising results for a pandemic-stopper design featuring a mix of M2e proteins from human, bird and pig influenza A viruses. They also found that their M2e-bearing nanoparticles remained in mouse lymph nodes, stimulating immune responses for many weeks, whereas non-nanoparticle-mounted M2e proteins were cleared from lymph nodes within hours of injection.

This suggests a very persistent engagement with the immune system, which we hope will enable our design to overcome the durability issue seen for earlier M2e-targeted vaccines, Zhu says.

Overall, he adds, the results demonstrate the potential of the M2e nanoparticle-mounted design to protect broadly against influenza A viruses.

A future version, Zhu says, might add influenza B M2e proteins, leading to a true pan-influenza vaccine. Such a vaccine, if proven effective, could significantly hobble influenzas ability to cause serious illness and mass-mortality pandemicstending to reduce it to something like a mild cold even in high-risk cases.

Uvax Bio, a spin-off vaccine company from Scripps Research, employs proprietary platform technology invented in Dr. Zhus lab at Scripps Research to develop and commercialize prophylactic vaccines for various infectious diseases. Zhu and the company are now considering their options for translating the new M2e design into a commercial flu vaccine.

Reference:Braz Gomes K, Zhang YN, Lee YZ, et al. Single-component multilayered self-assembling protein nanoparticles displaying extracellular domains of matrix protein 2 as a pan-influenza A vaccine. ACS Nano. 2023;17(23):23545-23567. doi: 10.1021/acsnano.3c06526

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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Nanoparticle-Based Flu Vaccine Shows Promise in Early Tests - Technology Networks

Scientific American

Experts say a pneumonia outbreak among children in Ohio anda cluster of pneumonia cases in Chinaare unrelated, despite some social media posts and tabloid articles that have ambiguously linked the two.

Theusual respiratory pathogensare making their rounds this cold and flu season, yet the specter of the pandemic has left many on alert for the next novel agent.

I understand outbreaks in China can make people nervous, but this is not that, saysPaul Offit, an infectious disease physician at Childrens Hospital of Philadelphia. Although another global illness may emerge in the future, the current pneumonia reports are nothing to worry about, he adds.

Many pathogens that circulate in the Northern Hemispheres winter and year-roundincluding flu, respiratory syncytial virus (RSV) and now COVIDare far from benign and can lead to pneumonia in some cases. But experts say there is no reason to panic or interpret the current uptick in illnesses as anything other than the typical circulation of respiratory viruses and bacteria.

These are just everyday pathogens that normally increase during the winter having a somewhat early and very assertive increase at the present time, saysWilliam Schaffner, an infectious disease physician and a professor at Vanderbilt University Medical Center. But people are not helpless against these germs, saysRama Thyagarajan, an infectious disease and internal medicine physician at the University of Texas at Austin Dell Medical School. COVID, the flu and RSV all have vaccines that can reduce the risk of pneumonia, she says.

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The Real Story Behind White Lung Pneumonia | The Transmission - University of Nebraska Medical Center

By Tom Polansek

CHICAGO, Dec 20 (Reuters) - The U.S. is detecting fewer cases of avian flu in wild birds that transmit the virus to poultry flocks, the agriculture department said, a potentially positive development for farmers and consumers after a two-year outbreak.

A top official warned that risks remain high, though, and urged farmers to maintain stringent safety and cleaning protocols to protect flocks. Record infections on poultry farms drove egg and turkey prices to all-time highs in 2022, raising costs for inflation-hit shoppers.

"We certainly don't want producers to drop their guard. But the viral load in the environment is less," Rosemary Sifford, chief veterinary officer for the U.S. Department of Agriculture, said in an interview.

Wild birds can carry the disease, known as bird flu, when migrating without showing signs of illness. Poultry can become infected through contaminated feces or direct contact.

The U.S. has reported about 2,600 cases in wild birds in 2023, compared to nearly 6,000 cases in 2022, according to a USDA database.

Experts said wild birds may have built immunity to the disease, which has also spread in Europe. However, new chicks hatched in summer nesting grounds are also part of migrations and could pose a threat.

"Young chicks are likely carrying the virus," Sifford said. "They would not yet have had the virus move through them and carry any immunity."

Since 2022, about 76.9 million U.S. chickens, turkeys and other birds have been wiped out by the disease, including more than 13 million in the last month, according to the USDA.

Cases in commercial poultry flocks have climbed since October, though infections in 2023 are down from 2022. Officials believe the decline correlates with the reduction in cases in wild birds, Sifford said.

"We're finding less positive cases, so we believe that correlates to a lower prevalence across the population," she said. "It's a positive development as long as we don't become complacent."

(Reporting by Tom Polansek in Chicago; Editing by David Gregorio)

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U.S. finds fewer cases of avian flu in wild birds, a good sign for poultry - Successful Farming

ExploreHealthy holiday: What can I do to make gatherings safer?

While public health experts emphasize COVID is still very much us, many families are approaching the holidays just as they did before the pandemic. Most adults in the U.S. about 75% say they are not worried about getting COVID over the holidays, according to a recent survey by KFF, formerly known as the Kaiser Family Foundation. Only 31% said they are worried they will spread COVID to people close to them.

The public is divided on taking precautions this upcoming season, with half of adults saying they are planning to take at least one of several precautions to limit the spread of COVID this fall and winter such as taking a COVID test before vising with family and friends, while the other half are not planning to take any of the precautions asked about in the survey.

Centers for Disease Control and Prevention Director Dr. Mandy Cohen has been on a nonstop tour, traveling the country to promote the need for vaccines. She points to immunization as the best defense against severe complications and hospitalizations from circulating viruses.

This year for the first time, vaccines are available for all three of these circulating viruses.

The respiratory and virus season is still upon us, said Dr. Luke Lathrop, chief medical officer at SmartMED Drive-Thru Medical Care in Roswell. The numbers of COVID are certainly lower this year compared to previous years but weve seen a good amount of COVID. Its still with us.

Heres what to know and how to stay safe from COVID, the flu, and RSV this holiday season.

Whats the latest on the big 3 seasonal viruses in Georgia?

New COVID hospitalizations are up slightly in Georgia, but they remain low compared to previous holiday seasons. The expected post-Thanksgiving surge has been more like a bump this year, and is smaller than the modest national rise in COVID. In Georgia, new COVID hospitalizations totaled 365 for the week ending Dec. 2. Thats up from 341 the previous week, a 7% increase. Nationally, new COVID hospitalizations increased by 18% over the same period.

Meanwhile, the latest flu report for the week ending Dec. 9 in Georgia shows the percentage of people going to the doctor for flu-like symptoms has reached 5.8% of all doctor visits. Since the start of the flu season in October, 511 people have been hospitalized in the eight-county metro Atlanta region (Fulton, DeKalb, Clayton, Cobb, Douglas, Gwinnett, Rockdale, and Newton) through Dec. 9, the most recent data available. A year ago, the total number of hospitalizations for this time period was 1,581.

RSV is also showing a declining trend after a recent surge. The latest data, which is based on a voluntary reporting program that includes hospitals in metro Atlanta, shows the overall rate of hospitalization for RSV is 1.7 per 100,000 people for the week ending Dec. 9. Thats down from a rate of 2.6 the previous week.

Dr. Jayne Morgan, executive director of health and community education for Piedmont Healthcare, noted COVID is still the virus causing the most hospitalizations and deaths.

Morgan said there is a sense of urgency to increase vaccinations as hospitalizations for these viruses are rising across the country. At the same time, doctors are also noting an uptick in other illnesses including strep throat and pneumonias, especially in children. Morgan said vaccinations against the three major respiratory illnesses can help lower the risk of other illnesses. This is because if you are infected with any of these viruses, it weakens your immune system and makes you more susceptible to other circulating respiratory infections as well, she said.

Credit: Contributed

Credit: Contributed

Could a surge still happen over the holidays?

Forecasting from CDC scientists predicts two possible scenarios for the holiday season. But neither forecast comes close to the staggeringly high levels of illness and hospitalization of the 2021-2022 winter season, when the original omicron variant dominated.

In both scenarios, COVID activity is predicted to be only moderate. Thats because most Americans 97% according to the CDC have some immunity to COVID through vaccination, infection, or both.

Which vaccines should I get and when?

COVID-19 Vaccines:

CDC recommends everyone 6 months and older get the COVID vaccine that was updated this year to protect against the potentially serious outcomes of COVID illness. New variants continue to surface, but the current formula still offers protection.

People who recently had COVID can hold off getting the vaccine for three months.

Flu vaccines:

Everyone 6 months of age and older should get vaccinated for the flu. Ideally, get the shot by the end of October but later is better than never. The seasonal flu vaccine is reformulated each year to tailor them to the virus types predicted to be most common in the upcoming season. Even when its not a perfect match, the shots can prevent serious illness.

RSV Vaccines

The CDC recommends the RSV vaccine for adults over 60 after having a conversation about it with their health care providers, something called shared clinical decision-making. Pregnant women are also recommended to get an RSV vaccine during their pregnancy. Babies born to mothers who get the RSV vaccine at least 2 weeks before delivery will have protection and, in most cases, should not need an RSV immunization later.

The CDC had recommended earlier all children under 8 months of age get an RSV shots, along with older infants at higher risk for severe disease. But due to an ongoing vaccine shortage, the CDC is now recommending doses be prioritized for children under 6 months of age and for infants with underlying conditions that place them at the highest risk for severe RSV disease.

How long do I have to isolate if I get COVID? What about the flu or RSV?

The CDC still says anyone who tests positive for COVID should isolate for at least five days. And for 10 days after testing positive, people should wear a high-quality mask such as a KN95 any time they are around other people.

So what if your holiday get-together falls within the first five days of testing positive? Unfortunately, youve got to stay home, said Lathrop. Youd feel pretty terrible if your holiday gift to your family member was COVID. The same goes for the flu or whatnot, he said.

Credit: custom

Credit: custom

And it can get trickier for those who get COVID but test negative or get a rebound of symptoms later. When symptoms rebound, the recommended isolation clock resets.

When it comes to the flu, people with flu are most contagious in the three to four days after their illness begins. The CDC recommends people with suspected or confirmed flu (even without fever) should stay home for four to five days after the onset of symptoms or for at least 24 hours after the fever is gone.

People with RSV are usually contagious for three to eight days and may become contagious a day or two before they start showing signs of illness.

What can I do to make my holiday gatherings safer?

At this stage in the pandemic, Lathrop said testing is no longer necessary for every occasion. But if high-risk guests are attending, such as older family members, newborns, or the immunocompromised, its wise to have everyone test beforehand.

The best thing you can do according to Dr. Lathrop is get vaccinated and stay home if you are sick.

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Just in time for the holidays: COVID-19, flu, RSV make their return in metro Atlanta, Georgia - The Atlanta Journal Constitution

Tis the season for making holiday plans and trying to avoid getting sick, but the increase of respiratory illnesses leading into the busy December season could make it difficult.

"Everyone is forgetting that COVID and flu and RSV are circulating, Dr. Abisola Olulade M.D., the Chief Impact Officer at Sharp Rees-Stealy, told NBC 7. We want it to go back to normal, but we are still in a time when all of these viruses are circulating, they can still cause issues.

According to the County of San Diego Health and Human Services Agencys respiratory virus surveillance report released on Dec. 14, there have been 26,448 cases of COVID-19, 3,973 cases of the flu and 2,327 cases of respiratory syncytial virus or RSV reported since Jul. 2 of this year.

The data suggests that cases of all three seem to be trending upward in recent weeks, but overall there are fewer cases when compared to recent years.

When we look at the number of cases, thats down compared to the year prior, significantly down, Olulade said. But, the important thing to remember is that those are an undercount, much more of an undercount, because most people that are testing for COVID are testing at home.

Olulade explained that the month-over-month uptick is not a surprise, considering that it is both winter and in between major holidays when people are more likely to travel and get together. So, it is not a time to let your guard down.

What were seeing from the CDC is that theyre predicting that this actually may be a slowdown before a ramp-up, and thats what we actually tend to see, Olulade said.

The data also shows fewer people seem to be getting their COVID vaccines or flu shots. One of the most vulnerable groups, those who are 65 years old or older, has less than 30% of people up-to-date on COVID vaccines and 53.4% of people who have gotten a flu shot.

Its important that we stay up-to-date on vaccinations, Olulade said. When we see people that end up in the hospital, in many cases, theyre not up-to-date on their shots.

She added that while they do not necessarily prevent you from getting sick, they do prevent serious illness and, as a result, possibly long COVID.

Its never too late to get the shot, always get it and always update it because you will get some protection, she said. Typically, you want to do it at least two weeks before the holidays or travel or gathering with people, but we would still expect that you get some protection overall.

Protection that, Olulade said, is going to be critical as we head into the next few weeks of festivities.

Were seeing a lot of people utilize our virtual urgent cares, so mild illnesses in most cases, but that can still cause a bottleneck in the healthcare system, she said.

Some of Olulades tips include having COVID tests on hand, because it is easier for medical professionals to treat you if they know what you do or dont have. She also suggested taking extra precautions in the week leading up to travel, by masking and washing your hands, to avoid getting sick pre-trip then becoming symptomatic when you reach your destination.

Every home in the U.S. is eligible to receive free at-home COVID tests through the U.S. Department of Health and Human Services. Learn more about how to get yours here.

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RSV, flu and COVID cases on the rise in San Diego, but less people are getting vaccinated: county data - NBC San Diego

These days, the background music of my life is a chorus of coughing and sneezing. At work, colleagues complain of scratchy throats and put illness emojis next to their names on Slack. At home, my daughter returns from day care with a backpack full of construction paper crafts and, more often than not, a runny nose.

No matter how much my husband and I wash our hands and hers the germs inevitably get passed on to our baby, and then to us. Sometimes it seems like theres barely a break before another illness hits.

Whether or not you have kids, it can feel as though you are stuck in a cycle of never-ending illness this time of year. Particularly since the pandemic, it may appear as if you and your family are sick more often, and that your colds are more severe and coughs drag on for longer.

To some extent, its simple math Covid now adds to the infectious diseases already spreading every virus season, said Dr. Nahid Bhadelia, founding director of Boston Universitys Center for Emerging Infectious Diseases Policy and Research. In addition to the flu and R.S.V., there are more than 200 viruses that cause cold-like symptoms, including enteroviruses, rhinoviruses, parainfluenza viruses and common cold coronaviruses that are cousins of the virus that causes Covid.

As far as experts can tell, these viruses havent changed to become more severe. But one reason they could feel more intense now is because our bodies have forgotten how to fight them off, Dr. Bhadelia said.

The precautions we all took to lower the transmission of Covid in the early days of the pandemic also slowed the spread of these other viruses, Dr. Bhadelia said.

So when people began ditching their masks and mingling more, they were exposed to a variety of illnesses again.

Last year, the flu, R.S.V. and Covid all surged together in a tripledemic. Earlier this year, the Centers for Disease Control and Prevention noted that cases of strep throat were on the rise. And norovirus, which can cause fevers and vomiting, is also back along with regular old colds.

Unfortunately, immunity to many of the viruses that make people sick doesnt last very long, Dr. Luis Ostrosky, chief of infectious diseases and epidemiology at UTHealth Houston and Memorial Hermann, said. That means your body has a sort of immunity debt to catch up on. If your immunity dates back to strains that were in circulation three or four years ago, youre needing to pay back, Dr. Ostrosky said.

Once your body relearns how to create antibodies against a particular virus, you will likely experience milder symptoms and recover faster if exposed again, Dr. Ostrosky said.

Covid has also made us far more attuned to when we are sick, experts said. It feels like a bigger deal now when someone shows up to work or school with a hacking cough. Pre-Covid, you would blow your nose and grumble a little bit, but you didnt talk about it quite as much, said Dr. William Schaffner, a professor of preventive medicine at the Vanderbilt University School of Medicine.

Paying closer attention to respiratory symptoms may also make it seem like were sick for longer, said Dr. Debra Langlois, a pediatrician at the University of Michigan Health C.S. Mott Childrens Hospital. But a 2013 review of common respiratory infections in children found that the time it takes for illness to resolve has always been staggering: It can take 15 days to clear a common cold, and 25 days for a cough to go away in most cases.

Adults can also have what doctors call a post-viral cough that lasts for three weeks or more after other symptoms go away. My own husband has had a post-viral cough for weeks, Dr. Langlois said.

And in some cases, its possible to develop a secondary infection in your sinuses, ears or throat that makes it seem like one illness is running into another. It really stinks to be sick back to back, Dr. Langlois said. But whats really reassuring to us as doctors is that even if you have a day or two or a week break, that means its a separate virus.

There are also steps that can curb at least some infections, Dr. Langlois said, such as getting vaccinated against R.S.V. if you are eligible; making sure you are up to date on flu and Covid shots; and applying other lessons from the pandemic, like staying home when youre sick and wearing a mask on airplanes.

For parents like me, with young children carrying every kind of germ imaginable, Dr. Langlois said theres reason to hope we wont keep getting sick so often: As children grow up, theyre a lot less likely to cough in your face and a lot more likely to wash their hands without a fight.

Read more:

Colds, Coughs, and Covid: Why it Feels Like Everyone Is Always Sick - The New York Times

As the mercury drops, the threat of winter illnesses go up. Influenza, a common winter illness, poses a significant risk to people. Kids, with their underdeveloped immune systems, not only face an elevated risk of contracting the flu but also grapple with severe complications. It is important to pay attention to symptoms such fever, body ache, runny nose, sore throat, tiredness, headache among others. Parents can play a major role in preventing their little ones from flu. From getting them vaccinated to instilling habits like washing hands frequently, not touching elevator doors, furniture and objects can help prevent the spread. Children should also avoid sharing their personal things with others. Eating a nutritious diet and avoiding junk food can also help boost their immunity. (See pics | Influenza to pneumonia: 5 common winter illnesses; how to prevent)

"Influenza, commonly known as the flu, can be particularly challenging for children during winter and is highly contagious. Unlike adults, children have less developed immune systems, making them more susceptible to severe complications from the flu virus. In addition, young kids often lack built-up immunity from previous exposure. One of the unique challenges of influenza in children is that it can easily spread in daycare centres and schools due to proximity and shared spaces," says Dr Manjusha Agarwal, Senior Consultant Internal Medicine Global Hospitals Parel Mumbai.

Influenza is very much preventable and must not be taken lightly as its symptoms be it fever, coughing or fatigue can disrupt their routine and affect their studies. Getting a flu shot can help prevent the infection.

"Remember, that one can have mild to major symptoms and may also require hospital admission. This makes prevention and containment efforts more complex. Moreover, symptoms such as high fever, coughing, and fatigue can disrupt a child's daily routine and lead to missed school days or activities. Parents should ensure their kids receive updated vaccinations each year to protect against new strains. Do not miss or skip the vaccination and try to speak to the doctor if you have any doubts. Parents should not worry as flu vaccines are completely safe for children," says Dr Agarwal.

"Encouraging regular hand washing and proper respiratory hygiene can also make a difference, as these simple practices help limit the spread of germs and viruses among children. Another handy tip is to maintain a healthy lifestyle for kids with balanced nutrition, regular exercise, and adequate sleep. Parents should ensure that their children eat a well-balanced diet consisting of fresh fruits, vegetables, whole grains, and pulses," says Dr Vrushali Bichkar, Consultant Paediatrician and Neonatologist, Motherhood Hospital, Lullanagar, Pune.

Dr Bichkar further elaborates on measures to ward off flu risk.

Avoid junk food: It is best to avoid junk, oily canned, and processed foods. Parents can take the help of an expert when it comes to diet for their children.

Proper hydration: Also, proper hydration is key to staying healthy. Drink plenty of water during the day and add hydrating fruits and vegetables to the diet

Do not touch surfaces: A strong immune system serves as a first line of defense against influenza. Avoiding close contact with sick individuals and teaching kids about the importance of not sharing personal items like utensils or water bottles can further reduce their risk of catching the flu during colder months.

"By prioritizing prevention strategies, parents and caregivers can help keep influenza at bay for their children as winter approaches. Parents should consult the doctor in case their children have symptoms such as high fever, cough, cold, chills, body pain, and weakness. Do not ignore these symptoms at all. Timely treatment can help children to deal with influenza. Children should stop touching their faces after touching any object," says Dr Bichkar.

"Apart from vaccination, children should wash their hands often with soap and water, especially before eating and after coughing, sneezing, wiping noses, and touching infected surfaces such as elevator doors, furniture, faucets, or objects. Avoid crowded places and being around sick people. Clean and disinfect frequently touched surfaces from time to time, wear masks, and maintain a safe distance from others. Children should avoid sharing any personal items with others. Also, children should eat nutritious diets and exercise to boost immunity and prevent influenza," adds Dr Agarwal.

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Flu season is here; important tips to prevent influenza in kids - Hindustan Times